Day one of adult trauma clinical: So I stay up until 1:15 a.m. working on the pathophysiology, drugs, nursing care plan, nursing diagnosis and plan of action for my patient and get to the hospital and am told that they discharged him. Which means that I get to try to find a patient to play with for the day. The night nurse decides that I can share a patient w/ my classmate because she’s “difficult” meaning that her O2 stats were in the 50’s all night long (we like to aim for 98-100% saturation in healthy adults). Came in from a fall as a result of a CVA (cerebral vascular accident - fancy talk for stroke) with a broken hip. The nurse who was responsible for her was too busy to come give us a status report (don’t even know if she had seen her at all) and the pt kept us busy enough trying to get her to respond to our voice, checking LOC, and doing a.m. care (pesky O2 masks…. the amount of oxygen needed to just keep her stats above 80 was so high that it dries out the mucous membranes and tongue - she had kept trying to take it off all night - if someone had just given her some good oral care consistently they could have improved her comfort) The first time we pass meds always takes the longest because you need to look up all the drugs, rates of administration, check for drug to drug interactions, etc. About 30 min after her meds got pushed the patient began sweating and her eyes rolled back in her head. I went out to track down her nurse and she came in and decided to call the doctors. She had heart sensors in place, connected to monitors at the nurses station (not in her room) and when we looked back we saw that she had flat lined for about 30-45 seconds before her heart started beating again. She did that 2 times. The daughter arrived at about that time, requested the discontinuation of any measures other than comfort. The doctor asked us if we had ever seen anyone die before, and that this is what it looked like. So we took off all the stockings, braces, blood pressure cuffs off of her and left her oxygen mask on, discontinued any medication besides morphine and left her with her daughter and son.

Tomorrow I’ll see if she’s still with us…..